Wednesday, August 3, 2011

Chronic Pain is Not a Symptom

I can remember a few years ago when I thought I understood chronic pain. Simply put, chronic pain is any pain that lasts more than six months. But when it happened to me, I responded in typical manner by researching chronic pain to better understand.

It was then I realized how shallow my understanding really was.

For many years, I medicated for nagging pain with over-the-counter NSAIDs. But since my RA decided to get really serious about attacking joints & organs, I have experienced constant, daily and unrelieved pain that just isn't touched by nonprescription pain medications.

I am one of the lucky ones. My rheumatologist asks about my pain, listens, and makes pain management an important element of my disease treatment plan. Through my participation in RA support groups, I have learned that her approach is somewhat uncommon. It is shocking to me that many, many RA patients report their rheums refuse to prescribe pain medications. Some even refuse to refer their patients to pain management clinics, or question the patient's description of pain, saying things like, "You have no joint damage, so you couldn't be in the pain you're describing." It's impossible for me to imagine how I would respond if a trusted doctor said that to me, but I suspect it wouldn't be pretty.

Effects of chronic pain are well-documented:

Sleep disturbances and resulting fatigue;
neurochemical changes that cause ever-increasing sensitivity to pain;
increased tension, anxiety and fear of injury;
weakened immune response;
depression and/or anger;
and more.

Consider that all of the items on that list are effects of Rheumatoid Arthritis (or its treatments) even without chronic pain. Add chronic pain, and it's no leap in logic to assume that one should attack both elements of the disease with equal vigor to achieve best results and a semblance of normalcy for your patient.

I believe that chronic pain is an integral part of my disease, not a symptom. And that treating that pain is as important to my overall health and ability to battle the disease as any of the other treatments I undergo.

I am very lucky that my rheumatologist knows the secret to compassionate treatment of RA and its sister Chronic Pain. I'd say that I wish she could share this secret with other docs who treat RA patients ... but that would be wrong.

Her secret is that she has RA.


Deb aka murphthesurf said...

AHA! I knew there was something there...your doc has RA. Of course! I mean Duh..why should we expect ra docs who don't have ra to treat the chronic pain? Your post hit the nail right on the head. It takes one to know one is the saying I am thinking right now. I get soooo angry with the lack of chronic pain management for ra patients. Loved this post!

The Rheuminator said...

Thanks for the support, Deb. I often think I was luckily led to my rheum because I don't suffer fools lightly, and I would have been the patient from hell for some of these poor docs who "don't get it."

Kelly said...

You know you're in for a good post when it starts out with, "Well, I thought I knew..."
Thanks for sharing your revelation & I liked the bit of suspense too. I have heard from a couple of docs with RA and it's an interesting situation.

Rachel said...

Wow! Absolutely amazing. "I believe that chronic pain is an integral part of my disease, not a symptom. And that treating that pain is as important to my overall health and ability to battle the disease as any of the other treatments I undergo."

You couldn't have said it any better. The whole post is the very end!

Anonymous said...

Great post. Right on the dot. Thank you for so eloquently giving words to what many of us feel.

Melissa said...

Loved this post. It's so true. My Rheumatologist is great to deal with, but he doesn't prescribe pain meds, he expects my family doctor to do that. Of course I'm currently without a family doctor, so that sucks.

I'm so glad you have a great Rheumy. I guess it works out in your favour that she has RA, because then she truly understands

jaszyperski said...

Please tell your doctor -thank you! What she is doing is wonderful and amazing.

I too thought I understood chronic pain... Then, same story, my RA got serious. The only way I can explain it to people is this - take the worst situation you have ever been through and times it by 10. You are still nowhere close to what it is like to be in constant pain with a debilitating disease.

tharr said...

I had often wondered if anyone had a rheumatologist that had RA. It is definitely to your advantage that she understands the disease so well. She can probably read how you are doing without you having to tell her most of the time.

Great post by the way.

Anonymous said...

Thank You